Torasemide – case report. Diuretic resistance in heart failure Case report

Abstract

Some patients with chronic heart failure despite of high doses of furosemide can not achieve the satisfactory diuretic effect. Lack of efficacy may be due to increased absorption of the sodium in the distal nephron or secondary activation of the renin-angiotensin-aldosterone axis which occur after the cessation of drug action. Overcoming of resistance is sometimes possible by increasing the dose and frequency of administration of furosemide or adding another loop or thiazide diuretic. Another way is changing furosemide into torasemide which shows less susceptibility to the development of resistance due to the longer half-life and an additional antialdosterone activity.